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Mira Fajarina
Universitas Bina Bangsa Getsempena
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PREDICTORS OF LATE INITIATION OF ANTENATAL CARE AMONG MUSLIM WOMEN IN PIDIE DISTRICT, ACEH Mira Fajarina; Reka Julia Utama; Gadis Halizasia; Fitria Fitria
Getsempena Health Science Journal Vol. 3 No. 2 (2024)
Publisher : Universitas Bina Bangsa Getsempena

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46244/ghsj.v3i2.1650

Abstract

Late initiation of antenatal care (ANC) remains a public health concern in Aceh, contributing to adverse maternal and neonatal outcomes. This study aimed to identify predictors of late ANC initiation and factors influencing ANC visit frequency among Muslim women in Pidie District. A predictive correlational study was conducted with 80 postpartum women selected using purposive sampling. Data were collected through structured questionnaires covering sociodemographic characteristics, obstetric history, knowledge, perceptions, beliefs, and social support. Analyses included descriptive statistics, Chi-square tests, Spearman correlation, and binary logistic regression. Results showed that 55% of participants initiated ANC after 12 weeks of gestation, with only 25% completing the recommended minimum of four visits. Key barriers included long distances to health facilities (62%), cultural or religious beliefs (35%), economic constraints (28%), and limited ANC knowledge (40%). Logistic regression identified significant predictors of late ANC initiation: distance from health facility (AOR = 1.08; p = 0.005), lower knowledge about ANC (AOR = 0.72; p = 0.03), and history of abortion (AOR = 6.12; p = 0.01). Family support, particularly from husbands, and guidance from community health volunteers were also influential in timely ANC attendance. In conclusion, both accessibility and maternal knowledge are key determinants of ANC utilization in Pidie. Interventions such as community-based education, telehealth support, and culturally sensitive counseling are recommended to improve timely ANC initiation and adherence, ultimately enhancing maternal and neonatal health outcomes.
Efektivitas penerapan audit maternal perinatal surveilans responsif (AMPSR) dalam mengidentifikasi faktor risiko kematian ibu Komala Kartikasari; Khalidah Khalidah; Reka Julia Utama; Mira Fajarina; Mahruri Saputra; Ristiani Ristiani
Hik Vol. 19 No. 9 (2025): Volume 19 Nomor 9
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/hjk.v19i9.1537

Abstract

Background: Maternal mortality remains a major challenge in Indonesia's health system, including in Banda Aceh. Responsive Maternal Perinatal Surveillance Audits (AMPSR) are recognized as a crucial strategy for reducing maternal mortality, but their implementation is often hampered by poor documentation quality, follow-up, and interprofessional team involvement. A Point of Care Quality Improvement (POCQI) approach is proposed to strengthen the audit's effectiveness. Purpose: To evaluate the effectiveness of the implementation of maternal perinatal audit responsive surveillance (AMPSR) in identifying risk factors for maternal mortality. Method: The study used a quasi-experimental one-group pretest-posttest design with a sample of 16 AMPSR team members at three healthcare facilities (Meuraxa Regional Hospital, Banda Aceh Women's Hospital, and Meuraxa Community Health Center). Data were collected through audit forms, compliance checklists, and POCQI questionnaires, then analyzed using the Wilcoxon Signed Rank Test and logistic regression. Results: POCQI training significantly improved knowledge (p=0.001), practice and documentation (p=0.001), audit effectiveness (p=0.000), and perceived barriers and support (p=0.025). Multivariate analysis showed that practice and documentation were the dominant factors influencing the effectiveness of AMPSR implementation (OR=4.75; p=0.017). Conclusion: The implementation of the POCQI-based AMPSR has proven effective in strengthening the capacity of interprofessional teams and improving the quality of maternal audits. This strategy has the potential to become a sustainable approach to maternal mortality prevention in Indonesia.   Keywords: Maternal Mortality; Maternal Perinatal Surveillance Responsive Audit (AMPSR); Risk Factors.   Pendahuluan: Angka kematian ibu masih menjadi tantangan besar dalam sistem kesehatan di Indonesia, termasuk di Kota Banda Aceh. Audit Maternal Perinatal Surveilans Responsif (AMPSR) diakui sebagai strategi penting untuk menurunkan angka kematian maternal, namun pelaksanaannya sering terkendala kualitas dokumentasi, tindak lanjut, serta keterlibatan tim lintas profesi. Pendekatan Point of Care Quality Improvement (POCQI) ditawarkan untuk memperkuat efektivitas audit. Tujuan: Untuk mengevaluasi efektivitas penerapan audit maternal perinatal surveilans responsif (AMPSR) dalam mengidentifikasi faktor risiko kematian ibu. Metode: Penelitian ini menggunakan desain quasi experiment one group pretest-posttest dengan sampel 16 anggota tim AMPSR di tiga fasilitas kesehatan (RSUD Meuraxa, RSIA Banda Aceh, dan Puskesmas Meuraxa). Data dikumpulkan melalui formulir audit, checklist kepatuhan, dan kuesioner POCQI, kemudian dianalisis menggunakan Wilcoxon Signed Rank Test dan regresi logistik. Hasil: Pelatihan POCQI meningkatkan secara signifikan pengetahuan (p=0.001), praktik dan dokumentasi (p=0.001), efektivitas audit (p=0.000), serta persepsi hambatan dan dukungan (p=0.025). Analisis multivariat menunjukkan bahwa praktik dan dokumentasi merupakan faktor dominan yang memengaruhi efektivitas penerapan AMPSR (OR=4.75; p=0.017). Simpulan: Penerapan AMPSR berbasis POCQI terbukti efektif dalam memperkuat kapasitas tim lintas profesi dan meningkatkan kualitas audit maternal. Strategi ini berpotensi menjadi pendekatan berkelanjutan dalam pencegahan kematian ibu di Indonesia.   Kata Kunci: Audit Maternal Perinatal Surveilans Responsif (AMPSR); Faktor Risiko; Kematian Ibu.
Dampak climate crisis terhadap pola penyakit ibu hamil dan maternal mortality Mira Fajarina; Reka Julia Utama; Rehmaita Malem
Hik Vol. 19 No. 9 (2025): Volume 19 Nomor 9
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/hjk.v19i9.1571

Abstract

Background: Climate change directly impacts maternal health, increasing the risk of pregnancy complications, delayed antenatal care (ANC) visits, and maternal mortality. Purpose: To analyze the impact of the climate crisis on maternal disease patterns and maternal mortality. Method: An observational analytic study with a case-control design was conducted on 364 pregnant women at the Baitussalam and Blang Bintang Community Health Centers in Aceh Besar. The sample was selected purposive sampling, consisting of case groups (mothers with complications) and controls. Data were collected using a validated questionnaire (CVI by three experts, Cronbach's Alpha ≥0.7) and medical records. Analysis used Chi-square and multiple logistic regression. Results: Exposure to extreme temperatures (OR=2.27; p=0.010), air pollution (OR=1.91; p=0.036), and weather changes (OR=2.85; p=0.006) were significantly associated with pregnancy complications, while counseling played a protective role (OR=0.49; p=0.010). Cancelling antenatal care due to extreme weather increases the risk of complications (OR=3.16; p=0.001). Conclusion: Environmental factors related to the climate crisis impact maternal health, necessitating mitigation strategies such as education, increasing access to antenatal care, and strengthening health system capacity to reduce the risk of maternal complications.   Keywords: Climate Crisis; Maternal Diseases; Maternal Mortality.   Pendahuluan: Perubahan iklim berdampak langsung pada kesehatan maternal, meningkatkan risiko komplikasi kehamilan, keterlambatan kunjungan antenatal care (ANC), dan mortalitas ibu. Tujuan: Untuk menganalisis dampak climate crisis terhadap pola penyakit ibu hamil dan maternal mortality. Metode: Studi observasional analitik dengan desain kasus-kontrol dilakukan pada 364 ibu hamil di Puskesmas Baitussalam dan Blang Bintang, Aceh Besar. Sampel dipilih secara purposive sampling, terdiri dari kelompok kasus (ibu dengan komplikasi) dan kontrol. Data dikumpulkan menggunakan kuesioner tervalidasi (CVI oleh tiga ahli, Cronbach’s Alpha ≥0.7) dan rekam medis. Analisis menggunakan Chi-Square dan regresi logistik berganda. Hasil: Paparan suhu ekstrem (OR=2.27; p=0010), polusi udara (OR=1.91; p=0.036), dan perubahan cuaca (OR=2.85; p=0.006) berhubungan signifikan dengan komplikasi kehamilan, sedangkan penyuluhan berperan protektif (OR=0.49; p=0.010). Batal ANC karena cuaca ekstrem meningkatkan risiko komplikasi (OR=3.16; p=0.001). Simpulan: Faktor lingkungan terkait krisis iklim memengaruhi kesehatan ibu hamil, sehingga diperlukan strategi mitigasi seperti penyuluhan, peningkatan akses ANC, dan penguatan kapasitas sistem kesehatan untuk mengurangi risiko komplikasi maternal.   Kata Kunci: Climate Crisis; Maternal Mortality; Penyakit Ibu Hamil.
Co-Authors Fitria Fitria Gadis Halizasia Khalidah Khalidah Komala Kartikasari Mahruri Saputra Rehmaita Malem Reka Julia Utama Ristiani Ristiani